Do you wonder what makes good medicine? Really good medicine. The sort of good medicine that will never be evident on a spreadsheet or publicly reported website. And surely not the ACE-I, statin, beta-blocker, get an echo, nuclear and cath kind of good medicine. Just read this. (It’s cyclist friendly, too.) JMM
Category: Doctoring
Why do doctors lose credibility? Consider the few public doctors out there with millions of followers. The majority of the stuff they recommend is perfect: eat good food, exercise, be nice. and sleep. Check. No problem. Everyone is good with that until they shatter the sense with nonsense. One miracle cure or stupid supplement or […]
This week is a good time to talk about trust in expert opinion and science. For the past forty years, nutrition experts in the US have warned us about cholesterol and fat. Eat too much of it and it will block your arteries, was the proclamation. Americans did what the scientists and experts said. They […]
This Wednesday Feb 11th, at 9 PM EST, one day after PBS Frontline features Dr. Atul Gawande and his new book Being Mortal, I will guest host the Hospice and Palliative Care (#HPM) Tweet Chat. Dr. Christian Sinclair is a physician leader in HPM and a co-editor of Pallimed. He recently commented on my stewardship piece […]
The medical decision–to have a screening mammogram, to take warfarin, to undergo a catheter ablation–is, at its core, a gamble. We pit the treasure of the win (benefit) against the pain of the loss (harm). In times past, medical gambles were easier. You took the antibiotic or you lost your leg. Most medical decisions today […]
My latest column over at theHeart.org discusses the disordered balance of power in the doctor-patient relationship. As most of you know, I harbor strong biases about the quality of medical decisions, especially in the elderly. Attached. Yes, I am attached to the issue of decision quality. Nearly all of electrophysiology, and much of cardiology, involves […]
My colleague and friend Dr. Melissa Walton-Shirley wrote a nice review article on antibiotics and cardiac issues over at theHeart.org. It is worth a look. MWS is a heck of writer. Although she is writing to doctors, the issues she raises about antibiotics are relevant to everyone. I recently reviewed a case in which a serious […]
Research now indicates 50% of middle–aged people live with one chronic disease. Translation: half of middle-aged people are not healthy. (You don’t need a reference there. Just walk out into the world and look around.) This new normal creates a challenge for caregivers. How will we care for the onslaught of chronic disease? Surely not […]
I knock, then enter the exam room. “Hi. My name is John Mandrola.” (Maybe it is my age but I am moving away from calling myself Doctor Mandrola.) “I am a heart rhythm specialist. I have looked at your chart so I know a little about your medical history.” “Can you tell me how you […]
What follows is an introduction to my most recent post on theHeart.org | Medscape Cardiology. It was published yesterday. Many of the comments are excellent. The link is at the end of this post. You might wonder what pool-safety has to do with lifestyle disease. Here is how they relate: I am currently reading an […]
When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a […]